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Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 92-0320-2357, 1993 Oct; :1-28

In response to a request from an employer representative at the 44th Street Independence Support Center (SIC-8399) (ISC) in New York, New York, an investigation was conducted on the potential for tuberculosis transmission due to contact with high risk clients. ISC was a drop in center for homeless clients with a history of mental illness. The screening program used by the ISC to determine the health status of the clients, including TB infection, was evaluated, as were the ventilation system in the building in which the ISC was housed and the effectiveness of germicidal ultraviolet radiation lamps installed to help with infection control. Of the 32 ISC clients tested for tuberculosis using the Mantoux skin test, ten were found to be positive; however no instances of PPD conversions were seen among the eight staff members. Fifty six percent of full time worker training employees, 40% of part time worker training employees, and one of the 22 permanent workers at a homeless shelter located in the same building tested positive to PPD. The authors conclude that a potential health hazard existed for workers exposed to clients who had active TB. The authors recommend that improvements be made in the program used to screen clients and staff members for tuberculosis, and in the ventilation system.